【正文】 Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at ACC/AHA 適應(yīng)證分類 ?III類 : ?根據(jù)病情狀況，專家們一致認(rèn)為起搏治療無(wú)效，某些情況下甚至對(duì)患者有害。 ? IIa類 : ? 證據(jù) /意見偏向有用 /有效。Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at 2021年 ACC/AHA/NASPE 心臟起搏器植入指南 Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at ACC/AHA 適應(yīng)證分類 ? I類 : ? 有明確證據(jù)或?qū)＜覀円恢抡J(rèn)為起搏治療對(duì)患者有益和有效。 ? II類 : ? 起搏治療是否給患者帶來(lái)益處 /有效的研究結(jié)果不一致 /專家們的意見有分歧。 ? IIb類 : ? 證據(jù) /意見不能說(shuō)明有用 /有效。 Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at Level A 為最有力的證據(jù)。 Level B 從含有較少量病人的有限次試驗(yàn)得出的數(shù)據(jù)或從設(shè)計(jì)較好的非隨機(jī)研究分析得出的數(shù)據(jù)或登記觀察的數(shù)據(jù) . Level C 專家共識(shí)是建議的主要來(lái)源 . ACC/AHA 臨床證據(jù)分類 Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at Section IA: 成人獲得性房室阻滯的起搏治療 Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at I 類適應(yīng)證 : 獲得性房室阻滯的起搏治療 高度 房室阻滯伴 : a)房室阻滯伴可能由心動(dòng)過(guò)緩所致的癥狀 (包括心力衰竭 ) b)需要藥物治療其他心律失?；蚱渌膊。盟幬镏委煂?dǎo)致癥狀性心動(dòng)過(guò)緩 c)清醒狀態(tài)下雖無(wú)癥狀，但證實(shí)心室停搏 逸搏心律 40 bpm Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at I 類適應(yīng)證 : 獲得性房室阻滯的起搏治療 d) 射頻消融后 e) 心臟外科手術(shù) 后發(fā)生的不可逆性房室阻滯 f) 神經(jīng)肌源性疾病伴發(fā)的房室阻滯， 無(wú)論是否有癥狀 2. 任何阻滯部位和類型的二度房室阻滯產(chǎn)生的癥狀性心動(dòng)過(guò)緩 Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at IIa 類適應(yīng)證 : 獲得性房室阻滯的起搏治療 ，清醒時(shí)平均心室率 40 bpm, 尤其是合并心肌病或左心室功能不全 II型房室阻滯， 伴窄 QRS波。 Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at IIa 類適應(yīng)證 : 獲得性房室阻滯的起搏治療 I 型房室阻滯，因其他原因電生理檢查發(fā)現(xiàn)阻滯部位在希氏束內(nèi)或以下水平。 Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at IIb 類適應(yīng)證 : 獲得性房室阻滯的起搏治療 ( sec.)合并左室功能不全或充血性心力衰竭癥狀的 ， 縮短 AV間期可能降低左心房充盈壓而改善心力衰竭癥狀者。 Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantat